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RESEARCH PRODUCT
Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy.
Gaetana Di FedeAlberto D'alcamoAnne Marie DittoF. CastelloMaria Luisa PacorNicola MartinelliVito DittaMaria Stefania Leto-baroneGabriele Di LorenzoClaudia Lo BiancoRizzo ManfrediPasquale MansuetoGiovam Battista Rinisubject
AdultMaleAllergySettore MED/09 - Medicina InternaRhinitis Allergic PerennialAdolescentmedicine.medical_treatmentImmunologyspecific IgEImmunoglobulin Eblood eosinophil countsYoung AdultBlood serummedicineImmunology and AllergyHumansreceiver operating characteristic curveAsthmaDesensitization (medicine)Retrospective StudiesSkin Testsserum s-IgE/total IgE ratio; allergen-specific immunotherapyHouse dust miteserum s-IgE/total IgE ratiobiologyserum-specific IgE/serum total IgE ratiobusiness.industryAllergen-specific immunotherapy; blood eosinophil counts; receiver operating characteristic curve; serum-specific IgE/serum total IgE ratio; specific IgE; total IgEArea under the curveImmunotherapyAllergensImmunoglobulin EMiddle Agedmedicine.diseasebiology.organism_classificationPrognosisAllergen-specific immunotherapyBlood Cell Counttotal IgEEosinophilsTreatment OutcomeDesensitization ImmunologicSpirometryImmunologybiology.proteinFemalebusinessdescription
Background: To date, no predictive tests for the clinical response to allergen-specific immunotherapy (ASI) are available. Therefore an in vivo or in vitro test would be of great value. Objective: We sought to evaluate pretreatment parameters used in diagnosing allergic rhinitis and determining serum specific IgE (s-IgE) levels, serum total IgE (t-IgE) levels, and blood eosinophil counts and to identify whether can be used to predict clinical improvement in monosensitized patients with allergic rhinitis with or without asthma treated with immunotherapy. Methods:We analyzed 279 patients who had undergone 4 years of ASI administered either by means of the subcutaneous immunotherapy (76 patients) or sublingual immunotherapy (203 patients) routes. Serum t-IgE and s-IgE levels, blood eosinophil counts, and serum s-IgE/t-IgE ratios were calculated and tested for correlation with clinical response to ASI. Receiver operating characteristic curves were determined. Predicted probabilities and predictive areas under the curve were calculated. Results: The clinical response to ASI was effective in 145 (52.0%) of 279 total patients, 42 (55.2%) of 76 patients treated with subcutaneous immunotherapy, and 103 (50.7%) of 203 patients treated with sublingual immunotherapy. A significant correlation was found between the serum s-IgE/t-IgE ratio and the clinical response to ASI, with high ratios (>16.2) associated with an effective response. The sensitivity and specificity of the area under the curve of the ratio were higher than those of serum s-IgE and t-IgE alone. Conclusion: The calculation of the serum s-IgE/t-IgE ratio for predicting the clinical response to ASI offers an advantage over measuring t-IgE and s-IgE levels in monosensitized patients for the following allergens: grass, Parietaria judaica, Olea europea, and house dust mite. Background: To date, no predictive tests for the clinical response to allergen-specific immunotherapy (ASI) are available. Therefore an in vivo or in vitro test would be of great value. Objective: We sought to evaluate pretreatment parameters used in diagnosing allergic rhinitis and determining serum specific IgE (s-IgE) levels, serum total IgE (t-IgE) levels, and blood eosinophil counts and to identify whether can be used to predict clinical improvement in monosensitized patients with allergic rhinitis with or without asthma treated with immunotherapy. Methods: We analyzed 279 patients who had undergone 4 years of ASI administered either by means of the subcutaneous immunotherapy (76 patients) or sublingual immunotherapy (203 patients) routes. Serum t-IgE and s-IgE levels, blood eosinophil counts, and serum s-IgE/t-IgE ratios were calculated and tested for correlation with clinical response to ASI. Receiver operating characteristic curves were determined. Predicted probabilities and predictive areas under the curve were calculated. Results: The clinical response to ASI was effective in 145 (52.0%) of 279 total patients, 42 (55.2%) of 76 patients treated with subcutaneous immunotherapy, and 103 (50.7%) of 203 patients treated with sublingual immunotherapy. A significant correlation was found between the serum s-IgE/t-IgE ratio and the clinical response to ASI, with high ratios (>16.2) associated with an effective response. The sensitivity and specificity of the area under the curve of the ratio were higher than those of serum s-IgE and t-IgE alone. Conclusion: The calculation of the serum s-IgE/t-IgE ratio for predicting the clinical response to ASI offers an advantage over measuring t-IgE and s-IgE levels in monosensitized patients for the following allergens: grass, Parietaria judaica, Olea europea, and house dust mite. © 2009 American Academy of Allergy, Asthma & Immunology.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2009-01-01 |